Factors related to non-compliance with active tuberculosis treatment in Montreal 1992-1995

OBJECTIVE: To determine the extent of non-compliance with antituberculosis treatment in Montreal and whether it is influenced by the characteristics of the health care setting. METHODS: Retrospective medical and public health chart review of tuberculosis patients reported to the Montreal-Centre Department of Public Health between 1992-1995. A non-compliant patient is defined as one who has taken less than 80% of prescribed antituberculosis medication. RESULTS: Among patients for whom the compliance status was available, 19.8% were non-compliant. In univariate analysis, risk factors significantly associated with non-compliance included: living alone, birth in an endemic country for tuberculosis, side effects related to the medication, and follow-up in a clinic not specialized for tuberculosis. In multivariate analysis, increase of age by one unit (OR: 1.1; 95% CI: 1.02-1.1), and risk factors such as alcoholism (OR: 33.8; 95% CI: 5.8-194.4) and being HIV positive (OR: 8.9; 95% CI: 2.9-26.6) were independently associated with non-compliance. CONCLUSION: Non-observance seemed to be associated with patients' characteristics rather than health care system characteristics.